Browsing by Author "Belay, Mastewal"

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    Management Profile of Rheumatoid Arthritis Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Two- year, Retrospective Chart Review
    (Addis Abeba University, 2021-12) Belay, Mastewal; Demelash, Birhanu (MD, Assistant Professor of Medicine)
    Background: Rheumatoid arthritis (RA), a chronic systemic inflammatory disease, predominantly affects the joints, leading to functional disability and premature mortality. Standards of care have been established for its treatment. Its management include early aggressive, and persistent use of disease-modifying antirheumatic drugs (DMARDs) to prevent joint damage in people with active inflammation. However, published evidence and guidance for its clinical management are lacking in resource limited countries such as Ethiopia. This research assesses whether care for RA is consistent with current treatment guidelines. Objective: To assess the management profile of RA patients who attended rheumatology outpatient care center of Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia from January 1 st , 2018 to December 31 st , 2019. Methodology: A facility-based, cross-sectional study was conducted at rheumatology outpatient care center of TASH, Addis Ababa, Ethiopia. Data was collected using a structured checklist, and then entered and analyzed using SPSS version 26. Descriptive analysis employed to identify the management gaps. Tables and figures were used to present the results. Results: The study evaluated medical records of 314 RA patients. Their age ranged from 18 to 74 years with a median of 39.5 years and IQR of 30 to 51. Females dominated with a female: male ratio of 5.4:1. RF was positive in 62.1% and anti-CCP was positive in 73.1% of the tested patients. Methotrexate was included in the regimen of most (93.6%) of the patients and chloroquine in 67.2% of them. Overall, 48.7% were on combination therapy. And 85.4% were subjected to steroids for more than six months. Baseline investigations were suboptimal. Objective measures of clinical remission were used in only 17.5% of the total. Successful clinical remission was achieved in 75.8% of patients. Non-pharmacological treatments such as physical therapy and psychological counseling were only delivered to 6.4% and 1% of patients, respectively. Conclusion: Management gap of RA patients is a common observation in the study setting. The most frequently observed management pitfalls are suboptimal use of DMARDs, use of steroids for extended duration, and underuse of non- pharmacological therapy such as physical therapy and psychological support.